Sleep disorders and psychological comorbidities in women with polycystic ovary syndrome - a cross-sectional study.

Abstract

Purpose: Polycystic ovary syndrome (PCOS) is a metabolic and hormonal disorder that affects physical and emotional well-being. The aim of this cross-sectional study was to assess associated factors like sleep disturbance, obstructive sleep apnea (OSA), anxiety and depression in a German-speaking population with PCOS.

Methods: We designed an anonymous online survey with items from validated questionnaires, including the Hospital Anxiety and Depression Scale (HADS), the Generalized Anxiety Disorder (GAD-7), the Pittsburgh Sleep Quality Index (PSQI) and the STOP-Bang questionnaire to screen for OSA. The survey was mainly distributed via social media in Austria, Germany and Switzerland. Data from 587 questionnaires were analyzed.

Results: Based on the STOP Bang questionnaire, 19.5% of women had a high probability for OSA. BMI and insulin resistance were identified as independent associated factors with OSA (both p < 0.001). Overall, the median anxiety score (GAD-7) was in the moderate range (Median 10.0, Interquartile range (IQR) 8.0). According to the HADS, association with moderate to severe anxiety (HADS-A) was 52.0% and with moderate to severe depression (HADS-D) 27.8%. There was a significant positive correlation between HADS-A/ HADS-D and BMI (r = 0.122, (HADS-A)/ r = 0.223 (HADS-D), both p < 0.01). According to the PSQI, 60.5% had mild sleep disturbance and 29.7% had chronic sleep disturbance. Chronic sleep disturbance was associated with anxiety disorders and depression, as well as a high probability of OSA (p < 0.001) after adjustment for age.

Conclusion: Our study highlights the probability of depression, anxiety and sleep disorders, including OSA, in women with PCOS and their association with BMI and insulin resistance.